| NPI | 1144410200 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY 25423) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: CA PSY 25423) |
| 103TC1900X Psychologist, Counseling (Licence: CA PSY 25423) | |
| 103TF0000X Psychologist, Family (Licence: CA PSY 25423) | |
| 106H00000X Marriage & Family Therapist (Licence: CA PSY 25423) | |
| Enumeration Date | 2007-07-25 |
| Last Update Date | 2023-03-14 |